Eliminating Racial Disparities in Cancer Outcomes
Going through cancer isn’t easy for anyone. However, there are groups with clear racial disparities in cancer outcomes. According to Gary Puckrein, Chief Executive Officer of the National Minority Quality Forum, “When we talk about disparities, what we’re really talking about is our healthcare system not performing well and getting poor outcomes for a cohort of patients in respective gender, race or age. We think that it’s important for the healthcare system to provide care to all populations.” Many public and private organizations have made a commitment to making advancements toward improved care. Here is a look at recent developments and collaborations toward eliminating racial disparities so ALL patients have optimal outcomes.
Findings From Collaborations on Eliminating Racial Disparities in Cancer Outcomes
Collaborative efforts have brought together a mix of patients, healthcare professionals, patient advocates, and industry experts to create a road map of guidelines to address racial disparities in care. Harvard Business School, multiple myeloma advocates, and acute leukemia advocates are just a few groups with recent notable collaborations and studies.
Harvard Business School Collaboration
Harvard Business School gathered leaders from a mix of nonprofit organizations, cancer centers, healthcare systems, universities, biotech and pharma companies including the American Association for Cancer Research (AACR), the National Cancer Institute (NCI), the National Institutes of Health (NIH), the Multiple Myeloma Research Foundation (MMRF), and others for the Harvard Business School Kraft Precision Medicine Accelerator. The program participants examined ways to reduce the mortality rate disparity for Black cancer patients in comparison to their white counterparts. The three-part strategy that emerged from the program will:
Centralize information about clinical trial sites and clinical registries to identify sites able to enroll more Black patients. Discussion during the accelerator revealed some key findings, including the fact that there is no central data repository about the number of Black patients with specific types of cancer at a site. To remedy this, a collaborative effort by public and private entities must occur to consolidate and share data about patient race, ethnicity, and disease as well as site experience, capabilities, infrastructure, commitment to diversity, and willingness to support registries and research.
Provide assistance to sites that have great potential to recruit Black patients for clinical trials and registries but with little experience. Nonprofit and government organizations can help locate and provide resources and infrastructure to bring more clinical trials to community-based healthcare organizations that have large numbers of Black cancer patients. Some of these recommended resources would include staff like clinical trial research associates, patient navigators, community liaisons, and care coordinators to help with clinical trial logistics.
Engage Black cancer patients to increase their awareness of and willingness to participate in trials and registries. Successful local and national programs by organizations like the NCI, the Black Coalition Against Cancer, Stand Up to Cancer, and others can be built upon to create collaborative and targeted efforts to increase Black patient clinical trial participation at community-based healthcare organizations.
Multiple Myeloma Clinical Trials
Multiple myeloma patients consistently face racial disparities. A collaboration by the FDA and the American Association for Cancer Research (AACR) gathered a group of patients, healthcare providers, researchers, regulators, and industry partners to develop guidelines to address the disparities. The guidelines addressed broad implementation to remedy issues including pre-approval clinical trials, post-approval clinical trials, and real-world data studies. Guideline recommendations include:
Broadening clinical trial eligibility criteria as much as possible and as appropriate.
Creation of a prospective and specific diversity study plan by clinical trial sponsors.
Appointing a diversity officer to Phase II and Phase III clinical trials to help with trial design and recruitment strategies.
Including common Black disease subtypes and disease features in clinical trials.
Monitoring of targets by trial sponsors and FDA review divisions confirming that study plans are in place as expected.
Conducting prespecified analyses in the postapproval setting to locate distinctions between subpopulations by race and ethnicity when safety signals or efficacy questions arise.
Compiling data to pool enough data to perform efficacy and safety analyses for racial and ethnic subpopulations.
Increasing diversity by creating strategies to clear obstacles to clinical, social, and socioeconomic access issues.
Incentivizing inclusiveness in clinical trials.
Using real-world data to study tolerability and efficacy in some multiple myeloma subpopulations from existing studies like Connect MM and INSIGHT MM.
Acute Leukemia Quality Improvement Program
Acute leukemia patients are another cancer group that has endured long-standing racial disparities. To find ways to help bridge these disparities, a study surveyed 30 hematologists/oncologists and 102 acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) patients. The patient group included 52 Black patients, 30 Hispanic patients, and 10 white patients. Compilation of study data showed that improving transportation programs for Black patients and access to a translator or to translated information can help move impacted patients toward equitable acute leukemia care.
The Future of Equitable Cancer Care
By creating recommended guidelines to diminish cancer disparities , the future of cancer care for Black, Indigenous, and People of Color (BIPOC) patients can have better outcomes. Many of the guidelines can be utilized to improve patient care beyond cancer care as well. By taking concrete action on these guidelines, healthcare professionals, patient advocates, and industry experts, can expand equitable care to BIPOC populations so that EVERYONE has the best outcomes.. The time is now to spark hope for the future of cancer care.
Sources
Nicole Gormley, Lola Fashoyin-Aje, Trevan Locke, Joseph M. Unger, Richard F. Little, Ajay Nooka, Khalid Mezzi, Mihaela Popa-McKiver, Rachel Kobos, Yelak Biru, Tiffany H. Williams, Kenneth C. Anderson. Recommendations on Eliminating Racial Disparities in Multiple Myeloma Therapies: A Step Toward Achieving Equity in Healthcare. Blood Cancer Discovery. Accessed February 8, 2023. https://aacrjournals.org/bloodcancerdiscov/article/2/2/119/2099/Recommendations-on-Eliminating-Racial-Disparities?guestAccessKey=e3198aee-abdd-4efc-9032-db03aece6370
Kathy Guisti and Richard G. Hamermesh. Reducing Racial Disparities in Cancer Outcomes. Harvard Business Review website. Accessed February 8, 2023. https://hbr.org/2022/01/reducing-racial-disparities-in-cancer-outcomes
Manali I. Patel, Jao L. Ascensao, Lindsay Gurska, Shelby Sullivan, Jeffrey D. Carter, Cherilyn Heggen, Addressing Racial Disparities to Advance Quality Care for Adults with Acute Leukemia: A Health Equity-Focused Quality Improvement Program. American Society of Hematology website. Accessed February 8, 2023. https://ashpublications.org/blood/article/140/Supplement%201/5098/489308/Addressing-Racial-Disparities-to-Advance-Quality
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